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Sun H, Feng Y, Tu S, Zhou J, Wang Y, Wei J, Zhang S, Hou Y, Shao Y, Ai H, Chen Z. Dopamine promotes osteogenic differentiation of PDLSCs by activating DRD1 and DRD2 during orthodontic tooth movement via ERK1/2 signaling pathway. Regen Ther 2024; 27:268-278. [PMID: 38617443 PMCID: PMC11015103 DOI: 10.1016/j.reth.2024.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/20/2024] [Accepted: 03/24/2024] [Indexed: 04/16/2024] Open
Abstract
Introduction Orthodontic tooth movement (OTM) involves complex interactions between mechanical forces and periodontal tissue adaptation, mainly mediated by periodontal ligament cells, including periodontal ligament stem cells (PDLSCs), osteoblasts, and osteoclasts. Dopamine (DA), a neurotransmitter known for its critical role in bone metabolism, is investigated in this study for its potential to enhance osteogenic differentiation in PDLSCs, which are pivotal in OTM. This study examined the potential of DA to facilitate OTM by binding to DA receptors (D1R and D2R) and activating the ERK1/2 signaling pathway. We propose that DA's interaction with these receptors on PDLSCs could enhance osteogenic differentiation, thereby accelerating bone remodeling and reducing the duration of orthodontic treatments, which offering a novel approach to improve clinical outcomes in orthodontic care. Methods This study utilized a rat OTM model, micro-CT, histological analyses, and in vitro assays to investigate dopamine's effect on osteogenesis. PDLSCs were cultured and treated with DA, and cytotoxicity, osteogenic differentiation, gene and protein expression assessed. Results Dopamine administration significantly increased trabecular bone density and osteogenic marker expression in an OTM rat model. In vitro, DA at 10 nM optimally promoted human PDLSCs osteogenesis without affecting proliferation. Blocking DA receptors or inhibiting the ERK1/2 pathway attenuated these effects, underscoring the importance of dopaminergic signaling in tension-induced osteogenesis during OTM. Conclusion Taken together, our study reveals that local dopamine administration at a concentration of 10 nM not only enhances tension-induced osteogenesis in vivo but also significantly promotes osteogenic differentiation of PDLSCs in vitro through D1 and D2 receptor-mediated ERK1/2 signaling pathway activation.
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Affiliation(s)
| | | | | | - Jianwu Zhou
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Yuxuan Wang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Jiaming Wei
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Sai Zhang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Yuluan Hou
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Yiting Shao
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Hong Ai
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Zheng Chen
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
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Weerasinghe DK, Hodge JM, Pasco JA, Samarasinghe RM, Azimi Manavi B, Williams LJ. Antipsychotic-induced bone loss: the role of dopamine, serotonin and adrenergic receptor signalling. Front Cell Dev Biol 2023; 11:1184550. [PMID: 37305679 PMCID: PMC10248006 DOI: 10.3389/fcell.2023.1184550] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Antipsychotics are commonly used in treating psychiatric disorders. These medications primarily target dopamine the serotonin receptors, they have some affinity to adrenergic, histamine, glutamate and muscarinic receptors. There is clinical evidence that antipsychotic use decreases BMD and increases fracture risk, with dopamine, serotonin and adrenergic receptor-signalling becoming an increasing area of focus where the presence of these receptors in osteoclasts and osteoblasts have been demonstrated. Osteoclasts and osteoblasts are the most important cells in the bone remodelling and the bone regeneration process where the activity of these cells determine the bone resorption and formation process in order to maintain healthy bone. However, an imbalance in osteoclast and osteoblast activity can lead to decreased BMD and increased fracture risk, which is also believed to be exacerbated by antipsychotics use. Therefore, the aim of this review is to provide an overview of the mechanisms of action of first, second and third generation antipsychotics and the expression profiles of dopamine, serotonin and adrenergic receptors during osteoclastogenesis and osteoblastogenesis.
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Affiliation(s)
- D. Kavindi Weerasinghe
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Jason M. Hodge
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Julie A. Pasco
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
- Department of Medicine—Western Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rasika M. Samarasinghe
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Behnaz Azimi Manavi
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Lana J. Williams
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
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Zhu X, Hu J, Xiao T, Huang S, Shang D, Wen Y. Integrating machine learning with electronic health record data to facilitate detection of prolactin level and pharmacovigilance signals in olanzapine-treated patients. Front Endocrinol (Lausanne) 2022; 13:1011492. [PMID: 36313772 PMCID: PMC9606398 DOI: 10.3389/fendo.2022.1011492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/27/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND AIM Available evidence suggests elevated serum prolactin (PRL) levels in olanzapine (OLZ)-treated patients with schizophrenia. However, machine learning (ML)-based comprehensive evaluations of the influence of pathophysiological and pharmacological factors on PRL levels in OLZ-treated patients are rare. We aimed to forecast the PRL level in OLZ-treated patients and mine pharmacovigilance information on PRL-related adverse events by integrating ML and electronic health record (EHR) data. METHODS Data were extracted from an EHR system to construct an ML dataset in 672×384 matrix format after preprocessing, which was subsequently randomly divided into a derivation cohort for model development and a validation cohort for model validation (8:2). The eXtreme gradient boosting (XGBoost) algorithm was used to build the ML models, the importance of the features and predictive behaviors of which were illustrated by SHapley Additive exPlanations (SHAP)-based analyses. The sequential forward feature selection approach was used to generate the optimal feature subset. The co-administered drugs that might have influenced PRL levels during OLZ treatment as identified by SHAP analyses were then compared with evidence from disproportionality analyses by using OpenVigil FDA. RESULTS The 15 features that made the greatest contributions, as ranked by the mean (|SHAP value|), were identified as the optimal feature subset. The features were gender_male, co-administration of risperidone, age, co-administration of aripiprazole, concentration of aripiprazole, concentration of OLZ, progesterone, co-administration of sulpiride, creatine kinase, serum sodium, serum phosphorus, testosterone, platelet distribution width, α-L-fucosidase, and lipoprotein (a). The XGBoost model after feature selection delivered good performance on the validation cohort with a mean absolute error of 0.046, mean squared error of 0.0036, root-mean-squared error of 0.060, and mean relative error of 11%. Risperidone and aripiprazole exhibited the strongest associations with hyperprolactinemia and decreased blood PRL according to the disproportionality analyses, and both were identified as co-administered drugs that influenced PRL levels during OLZ treatment by SHAP analyses. CONCLUSIONS Multiple pathophysiological and pharmacological confounders influence PRL levels associated with effective treatment and PRL-related side-effects in OLZ-treated patients. Our study highlights the feasibility of integration of ML and EHR data to facilitate the detection of PRL levels and pharmacovigilance signals in OLZ-treated patients.
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Affiliation(s)
- Xiuqing Zhu
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Jinqing Hu
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Tao Xiao
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Research, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Shanqing Huang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Dewei Shang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
- *Correspondence: Dewei Shang, ; Yuguan Wen,
| | - Yuguan Wen
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
- *Correspondence: Dewei Shang, ; Yuguan Wen,
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The role of oxidative stress in ovarian toxicity induced by haloperidol and clozapine—a histological and biochemical study in albino rats. Cell Tissue Res 2019; 378:371-383. [DOI: 10.1007/s00441-019-03067-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 07/01/2019] [Indexed: 12/20/2022]
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Zheng L, Yang L, Zhao X, Long N, Li P, Wang Y. Effect of risperidone on proliferation and apoptosis of MC3T3-E1 cells. ACTA ACUST UNITED AC 2019; 52:e8098. [PMID: 30810624 PMCID: PMC6393850 DOI: 10.1590/1414-431x20188098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/28/2018] [Indexed: 02/06/2023]
Abstract
This aim of this study was to assess the molecular mechanism of osteoporosis in schizophrenia patients with risperidone use. Here, we investigated the effects of risperidone on cellular proliferation and apoptosis of a preosteoblast cell line, MC3T3-E1. Cell viability and apoptotic rate of MC3T3-E1 were detected by cell counting kit-8 and flow cytometry at a serial dose of risperidone and at different time points, respectively. Bone transformation relevant gene serum osteocalcin (BGP), collagen 1, tumor necrosis factor-α (TNF-α), osteoprotegerin (OPG), and receptor activator of nuclear factor-κB ligand (RANKL) mRNA levels were determined by real-time PCR (qPCR). Their protein expression patterns were evaluated using western blot. The results revealed that risperidone dramatically inhibited MC3T3-E1 cell proliferation in a dose-dependent manner. It also significantly induced MC3T3-E1 cell apoptosis. TNF-α gene and protein levels were greatly enhanced after risperidone treatment. In contrast, BGP, collagen 1, OPG, and RANKL gene and protein levels were markedly downregulated. Our study indicated that risperidone suppressed MC3T3-E1 cell proliferation and induced apoptosis. It also regulated BGP gene and protein expression.
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Affiliation(s)
- Lei Zheng
- Department of Mental Health and Psychiatry, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.,Department of Psychiatry, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Lixia Yang
- Department of Psychiatry, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Xin Zhao
- The Sixth People's Hospital of Guiyang, Guiyang, Guizhou, China
| | - Niya Long
- Guizhou Medical University, Guiyang, Guizhou, China
| | - Peifan Li
- Department of Psychiatry, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Yiming Wang
- Department of Psychiatry, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
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Radojkovic D, Pesic M, Radojkovic M, Dimic D, Vukelic Nikolic M, Jevtovic Stoimenov T, Radenkovic S, Velojic Golubovic M, Radjenovic Petkovic T, Antic S. Expression of prolactin receptors in the duodenum, kidneys and skeletal system during physiological and sulpiride-induced hyperprolactinaemia. Endocrine 2018; 62:681-691. [PMID: 30143940 DOI: 10.1007/s12020-018-1730-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION AND AIM Hyperprolactinaemia in pregnancy leads to mild and reversible changes in the maternal skeletal system, and medicamentous hyperprolactinemia causes more detrimental effects. We conducted an experimental study to evaluate differences between Prlr gene expression in the duodenum, vertebrae and kidneys during physiological and medicamentous hyperprolactinaemia, which could influence calcium homeostasis. METHODS Experimental animals (18 weeks old, Wistar female rats) were divided as follows: group P (nine rats that were 3 weeks pregnant), group M (ten rats that were intramuscularly administrated sulpiride (10 mg/kg) twice daily for 3 weeks), and the control group (C, ten age-matched nulliparous rats, 18-week-old). Laboratory investigations included measurements of serum ionized calcium, phosphorus, urinary calcium and phosphorus excretion, osteocalcin (OC), serum procollagen type 1 N-terminal propeptide (P1NP), vitamin D, parathyroid hormone (PTH) and prolactin (PRL). Relative quantification of gene expression for prolactin receptors in the duodenum, vertebrae and kidneys was determined using real-time PCR. RESULTS Expression of the Prlr gene was significantly higher in the duodenum (p < 0.001) and lower in vertebrae (p < 0.001) and kidneys (p < 0.01) in rats with physiological hyperprolactinaemia (PHP) than in the control group. Significantly lower Prlr expression in the duodenum was verified (p < 0.001), along with increased Prlr gene expression in vertebrae (p < 0.001) and kidneys (p < 0.01), in rats with medicamentous hyperprolactinaemia (MHP) than in the C group. CONCLUSIONS Downregulation of Prlr gene expression in the duodenum may explain the diminished intestinal calcium absorption in medicamentous hyperprolactinaemia. Prolactin takes calcium from the skeletal system following increased Prlr gene expression in the vertebrae to maintain calcium homeostasis, which increases the harmful effect on bone metabolism compared to that of physiological hyperprolactinaemia.
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Affiliation(s)
- Danijela Radojkovic
- Medical Faculty, University of Nis, Blvd.dr Zoran Djindjic 81, 18000, Nis, Serbia.
- Clinic of Endocrinology, Diabetes and Metabolic disorders, Clinical Center Nis, Serbia Vojislav Ilic bb, 18000, Nis, Serbia.
| | - Milica Pesic
- Medical Faculty, University of Nis, Blvd.dr Zoran Djindjic 81, 18000, Nis, Serbia
- Clinic of Endocrinology, Diabetes and Metabolic disorders, Clinical Center Nis, Serbia Vojislav Ilic bb, 18000, Nis, Serbia
| | - Milan Radojkovic
- Medical Faculty, University of Nis, Blvd.dr Zoran Djindjic 81, 18000, Nis, Serbia
- Surgery Clinic, Clinical Center Nis, Vojislav Ilic bb, 18000, Nis, Serbia
| | - Dragan Dimic
- Medical Faculty, University of Nis, Blvd.dr Zoran Djindjic 81, 18000, Nis, Serbia
- Clinic of Endocrinology, Diabetes and Metabolic disorders, Clinical Center Nis, Serbia Vojislav Ilic bb, 18000, Nis, Serbia
| | | | | | - Sasa Radenkovic
- Medical Faculty, University of Nis, Blvd.dr Zoran Djindjic 81, 18000, Nis, Serbia
- Clinic of Endocrinology, Diabetes and Metabolic disorders, Clinical Center Nis, Serbia Vojislav Ilic bb, 18000, Nis, Serbia
| | - Milena Velojic Golubovic
- Medical Faculty, University of Nis, Blvd.dr Zoran Djindjic 81, 18000, Nis, Serbia
- Clinic of Endocrinology, Diabetes and Metabolic disorders, Clinical Center Nis, Serbia Vojislav Ilic bb, 18000, Nis, Serbia
| | | | - Slobodan Antic
- Medical Faculty, University of Nis, Blvd.dr Zoran Djindjic 81, 18000, Nis, Serbia
- Clinic of Endocrinology, Diabetes and Metabolic disorders, Clinical Center Nis, Serbia Vojislav Ilic bb, 18000, Nis, Serbia
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Teerapornpuntakit J, Chanprapaph P, Charoenphandhu N. Previous Adolescent Pregnancy and Breastfeeding Does Not Negatively Affect Bone Mineral Density at the Age of Peak Bone Mass. Breastfeed Med 2018; 13:500-505. [PMID: 30156423 DOI: 10.1089/bfm.2018.0080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To determine bone mineral density (BMD) at the age of peak bone mass in women who previously experienced pregnancy and breastfeeding during adolescence. MATERIALS AND METHODS In this retrospective study, female volunteers aged 24-30 years who were pregnant during the age of 15-19 years and have had one to two babies were recruited. All of them experienced breastfeeding without history of bone- or calcium-related problems, such as fracture or low calcium intake. BMD was determined at the femur and L1-L4 spine by dual-energy X-ray absorptiometry. RESULTS We found that both volunteers who previously experienced breastfeeding and age-matched control volunteers had similar BMD at the L1-L4 spines and femora. Further analysis for site-specific changes of lumbar and femoral BMDs showed that the values of the breastfeeding group were not different from those of the control group except at L1 and L2, where BMD values were greater in breastfeeding group compared with the control group. At both femoral and vertebral sites, T- and Z-scores were apparently similar between the two groups. In addition, the BMD at peak bone mass had no significant correlation with breastfeeding duration. CONCLUSIONS Teenage pregnancy and breastfeeding did not negatively affect BMD later at the age of peak bone mass. Therefore, breastfeeding can be encouraged in teenage mothers.
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Affiliation(s)
- Jarinthorn Teerapornpuntakit
- 1 Center of Calcium and Bone Research (COCAB), Faculty of Science, Mahidol University , Bangkok, Thailand .,2 Department of Physiology, Faculty of Medical Science, Naresuan University , Phitsanulok, Thailand
| | - Pharuhas Chanprapaph
- 3 Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok, Thailand
| | - Narattaphol Charoenphandhu
- 1 Center of Calcium and Bone Research (COCAB), Faculty of Science, Mahidol University , Bangkok, Thailand .,4 Department of Physiology, Faculty of Science, Mahidol University , Bangkok, Thailand .,5 Institute of Molecular Biosciences, Mahidol University , Nakhon Pathom, Thailand .,6 The Academy of Science , The Royal Society of Thailand, Dusit, Bangkok, Thailand
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Nikolić T, Petronijević N. Schizophrenia and osteoporosis. MEDICINSKI PODMLADAK 2018. [DOI: 10.5937/mp69-17304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Nikolić T, Petronijević M, Sopta J, Velimirović M, Stojković T, Jevtić Dožudić G, Aksić M, Radonjić NV, Petronijević N. Haloperidol affects bones while clozapine alters metabolic parameters - sex specific effects in rats perinatally treated with phencyclidine. BMC Pharmacol Toxicol 2017; 18:65. [PMID: 29020988 PMCID: PMC5637335 DOI: 10.1186/s40360-017-0171-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 10/03/2017] [Indexed: 01/26/2023] Open
Abstract
Background The presentation of schizophrenia (SCH) symptoms differs between the sexes. Long-term treatment with antipsychotics is frequently associated with decreased bone mineral density, increased fracture risk and metabolic side effects. Perinatal phencyclidine (PCP) administration to rodents represents an animal model of SCH. The aim of this study was to assess the effects of chronic haloperidol and clozapine treatment on bone mass, body composition, corticosterone, IL-6 and TNF-α concentrations and metabolic parameters in male and female rats perinatally treated with PCP. Methods Six groups of male and six groups of female rats (n = 6-12 per group) were subcutaneously treated on 2nd, 6th, 9th and 12th postnatal day (PN), with either PCP (10 mg/kg) or saline. At PN35, one NaCl and PCP group (NaCl-H and PCP-H) started receiving haloperidol (1 mg/kg/day) and one NaCl and PCP group (NaCl-C and PCP-C) started receiving clozapine (20 mg/kg/day) dissolved in drinking water. The remaining NaCl and PCP groups received water. Dual X-ray absorptiometry measurements were performed on PN60 and PN98. Animals were sacrificed on PN100. Femur was analysed by light microscopy. Concentrations of corticosterone, TNF-α and IL-6 were measured in serum samples using enzyme-linked immunosorbent assay (ELISA) commercially available kits. Glucose, cholesterol and triacylglycerol concentrations were measured in serum spectrophotometrically. Results Our results showed that perinatal PCP administration causes a significant decrease in bone mass and deterioration in bone quality in male and female rats. Haloperidol had deleterious, while clozapine had protective effect on bones. The effects of haloperidol on bones were more pronounced in male rats. It seems that the observed changes are not the consequence of the alterations of corticosterone, IL-6 and TNF-α concentration since no change of these factors was observed. Clozapine induced increase of body weight and retroperitoneal fat in male rats regardless of perinatal treatment. Furthermore, clozapine treatment caused sex specific increase in pro-inflammatory cytokines. Conclusion Taken together our findings confirm that antipsychotics have complex influence on bone and metabolism. Evaluation of potential markers for individual risk of antipsychotics induced adverse effects could be valuable for improvement of therapy of this life-long lasting disease. Electronic supplementary material The online version of this article (10.1186/s40360-017-0171-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tatjana Nikolić
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Petronijević
- Military Medical Academy, Clinic of Rheumatology, University of Defence, Belgrade, Serbia
| | - Jelena Sopta
- Institute of Pathology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milica Velimirović
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tihomir Stojković
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Gordana Jevtić Dožudić
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Aksić
- Institute of Anatomy "Niko Miljanic", School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nevena V Radonjić
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Nataša Petronijević
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia.
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Robledo-González LE, Martínez-Martínez A, Vargas-Muñoz VM, Acosta-González RI, Plancarte-Sánchez R, Anaya-Reyes M, Fernández Del Valle-Laisequilla C, Reyes-García JG, Jiménez-Andrade JM. Repeated administration of mazindol reduces spontaneous pain-related behaviors without modifying bone density and microarchitecture in a mouse model of complete Freund's adjuvant-induced knee arthritis. J Pain Res 2017; 10:1777-1786. [PMID: 28794657 PMCID: PMC5538698 DOI: 10.2147/jpr.s136581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background The role of dopaminergic system in the development of rheumatoid arthritis-related pain, a major symptom in this disease, has not been explored. Therefore, the anti-nociceptive effect of mazindol, a dopamine uptake inhibitor, was evaluated in a model of complete Freund’s adjuvant (CFA)-induced arthritis. Furthermore, as studies have shown that the dopaminergic system regulates bone metabolism, the effect of mazindol on bone mass and microarchitecture was determined. Methods Adult ICR male mice received intra-articular injections of either CFA or saline into the right knee joint every week. Spontaneous pain-like behaviors (flinching and guarding) and locomotor activity were assessed at day 26 post-first CFA, following which, a single intraperitoneally (i.p.) administered dose of mazindol was given (1, 3 and 10 mg/kg). Then, the antinociceptive effect of a repeated administration of 3 mg/kg mazindol (daily, i.p.; day 15–day 26) was evaluated. Additionally, at day 26, the participation of D1-like, D2-like or opioid receptors in the antinociceptive effect of mazindol was evaluated. The effect of mazindol on bone density and microarchitecture was evaluated by micro-computed tomography. Results Acute administration of mazindol decreased the spontaneous pain-like behaviors in a dose-dependent manner without reducing the knee edema. However, mazindol at 10 mg/kg significantly increased the locomotor activity; therefore, 3 mg/kg mazindol was used for further studies. Repeated administration of 3 mg/kg mazindol significantly decreased the pain-like behaviors without modifying locomotor activity. The antinociceptive effect of mazindol was blocked by administration of a D2-like receptor antagonist (haloperidol), but not by administration of D1-like receptor antagonist (SCH 23390) or an opioid receptor antagonist (naloxone). Repeated administration of mazindol did not significantly modify the density and microarchitecture of periarticular bone of the arthritic and nonarthritic knee joints. Conclusion Results suggest that mazindol via D2-like receptors has an antinociceptive role in mice with CFA-induced knee arthritis without modifying the bone health negatively.
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Affiliation(s)
| | | | | | - R I Acosta-González
- Departamento de Análisis Clínicos, Unidad Académica Multidisciplinaria Reynosa-Aztlán, UAT, Reynosa, Tamaulipas, Mexico
| | - R Plancarte-Sánchez
- Departamento de Anestesiología, Terapia Intensiva y Clínica del Dolor, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | | | - J G Reyes-García
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
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Krishna G, Gopalakrishnan G, Goel S. Toxicity assessment of molindone hydrochloride, a dopamine D2/D5 receptor antagonist in juvenile and adult rats. Toxicol Mech Methods 2017; 27:352-362. [DOI: 10.1080/15376516.2017.1288768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | - Saryu Goel
- Supernus Pharmaceuticals Inc., Rockville, MD, USA
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Tal T, Kilty C, Smith A, LaLone C, Kennedy B, Tennant A, McCollum CW, Bondesson M, Knudsen T, Padilla S, Kleinstreuer N. Screening for angiogenic inhibitors in zebrafish to evaluate a predictive model for developmental vascular toxicity. Reprod Toxicol 2016; 70:70-81. [PMID: 28007540 DOI: 10.1016/j.reprotox.2016.12.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 12/06/2016] [Accepted: 12/16/2016] [Indexed: 01/21/2023]
Abstract
Chemically-induced vascular toxicity during embryonic development may cause a wide range of adverse effects. To identify putative vascular disrupting chemicals (pVDCs), a predictive pVDC signature was constructed from 124 U.S. EPA ToxCast high-throughput screening (HTS) assays and used to rank 1060 chemicals for their potential to disrupt vascular development. Thirty-seven compounds were selected for targeted testing in transgenic Tg(kdrl:EGFP) and Tg(fli1:EGFP) zebrafish embryos to identify chemicals that impair developmental angiogenesis. We hypothesized that zebrafish angiogenesis toxicity data would correlate with human cell-based and cell-free in vitro HTS ToxCast data. Univariate statistical associations used to filter HTS data based on correlations with zebrafish angiogenic inhibition in vivo revealed 132 total significant associations, 33 of which were already captured in the pVDC signature, and 689 non-significant assay associations. Correlated assays were enriched in cytokine and extracellular matrix pathways. Taken together, the findings indicate the utility of zebrafish assays to evaluate an HTS-based predictive toxicity signature and also provide an experimental basis for expansion of the pVDC signature with novel HTS assays.
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Affiliation(s)
| | - Claire Kilty
- UCD School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Andrew Smith
- UCD School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | | | - Brendán Kennedy
- UCD School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | | | - Catherine W McCollum
- Center for Nuclear Receptors and Cell Signaling, University of Houston, Houston, TX, USA
| | - Maria Bondesson
- Center for Nuclear Receptors and Cell Signaling, University of Houston, Houston, TX, USA; Department of Pharmacological and Pharmaceutical Sciences, University of Houston, Houston, TX, USA
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Liang Y, Huang J, Tian JB, Cao YY, Zhang GL, Wang CG, Cao Y, Li JR. Factors associated with decreased bone mineral density in postmenopausal women with schizophrenia. Clin Interv Aging 2016; 11:153-7. [PMID: 26937181 PMCID: PMC4762469 DOI: 10.2147/cia.s100274] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective This study examined the risk factors for decreased bone mineral density (BMD) in postmenopausal women with schizophrenia. Methods Cluster sampling method was adopted in this large-sample, cross-sectional study. A total of 219 postmenopausal female inpatients with schizophrenia were selected and interviewed in Beijing. The average age of the patients was 60.4±7.0 years. Clinical assessment instruments included the Positive and Negative Syndrome Scale (PANSS) and a questionnaire with detailed general information and disease-related investigations. Laboratory measurements included prolactin (PRL), estradiol, progesterone, thyroid stimulating hormone, FT3, and FT4. BMD testing was performed by dual-energy X-ray absorptiometry. Results The prevalence of osteoporosis or osteopenia was 66.2% (n=145). Decreased BMD was associated with age, illness duration, therapeutic dose (equivalent chlorpromazine dose), treatment duration, PANSS-negative scores, body mass index (BMI), daily exercises (min/d), drinking (unit/wk), PRL, and estradiol. Multiple logistic regression analysis revealed that age, treatment duration, PANSS-negative score, BMI, and PRL were significantly associated with decreased BMD. Conclusion Prevalence of BMD loss was higher in Chinese postmenopausal women with schizophrenia compared to the normal BMD group. A combination of demographic and clinical factors play important roles in determining decreased BMD, including older age, longer treatment duration, more PANSS-negative scores, higher BMI, and higher PRL level.
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Affiliation(s)
- Ying Liang
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Institute of Mental Health, and the Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, People's Republic of China
| | - Jian Huang
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Institute of Mental Health, and the Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, People's Republic of China
| | - Jing-bin Tian
- Psychiatry Department, Changping District Hospital of Integrated Chinese and Western Medicine, Beijing, People's Republic of China
| | - Yuan-yuan Cao
- Psychiatry Department, Changping District Hospital of Integrated Chinese and Western Medicine, Beijing, People's Republic of China
| | - Guo-ling Zhang
- Psychiatry Department, Changping District Hospital of Integrated Chinese and Western Medicine, Beijing, People's Republic of China
| | - Chun-gang Wang
- Psychiatry Department, Changping District Hospital of Integrated Chinese and Western Medicine, Beijing, People's Republic of China
| | - Ying Cao
- Psychiatry Department, Changping District Hospital of Integrated Chinese and Western Medicine, Beijing, People's Republic of China
| | - Jian-rong Li
- Psychiatry Department, Changping District Hospital of Integrated Chinese and Western Medicine, Beijing, People's Republic of China
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Zamani Z, Zare S, Sadrkhanlou R, Ahmadi A, Movahed E. The Effects of Chlorpromazine on Reproductive System and Function in Female Rats. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015; 9:371-9. [PMID: 26644861 PMCID: PMC4671389 DOI: 10.22074/ijfs.2015.4553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 06/24/2014] [Indexed: 11/29/2022]
Abstract
Background Chlorpromazine (CPZ), an antipsychotic drug, is associated with increased
risk of sexual dysfunction through increasing prolactin levels. The current study evaluates the effect of CPZ-induced hyperprolactinemia on ovarian follicular growth, gonadotropins, and alteration of ovarian source hormones. Materials and Methods In this experimental study, animals were divided into four
groups, control and CPZ (n=8 per group). In the treated groups, CPZ was administered
by gavage at doses of 3, 10 and 30 mg/kg per day for 28 days. On day 29 the animals
were killed after which histopathological and histomorphometric analyses of the ovaries
were performed. We evaluated the levels of prolactin serum, luteinizing hormone (LH),
follicle-stimulating hormone (FSH), estradiol (E2) and progesterone. Results The ovaries of the test groups showed numerous atretic follicles of various
sizes. CPZ caused a significant difference between the test groups and the control group
(P<0.05) on the amount of atresia and the size of the normal corpora lutea (CL). The increased dysfunction of the ovaries from the different groups depended on the amount of
CPZ administered. The serum concentrations of prolactin and progesterone significantly
increased (P<0.05), while the serum concentrations of estradiol, LH and FSH notably
decreased (P<0.05), depending on the CPZ dose. CPZ-induced animals had unsuccessful
mating and decreased pregnancy rate. Conclusion The present findings suggest that CPZ-induced disturbances not only depend
on prolactin level but the increased prolactin level is largely dose-dependent.
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Affiliation(s)
- Zahra Zamani
- Department of Biology, Faculty of Science , Urmia University, Urmia, Iran
| | - Samad Zare
- Department of Biology, Faculty of Science , Urmia University, Urmia, Iran
| | - Rajabali Sadrkhanlou
- Laboratory of Embryology, Department of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Abbas Ahmadi
- Laboratory of Embryology, Department of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Elham Movahed
- Department of Biology, Faculty of Science , Urmia University, Urmia, Iran
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Krishna G, Ganiger S, Kannan K, Gopalakrishnan G, Goel S. Reversibility of dopamine receptor antagonist-induced hyperprolactinemia and associated histological changes in Tg RasH2 wild-type mice. Reprod Toxicol 2015; 58:73-8. [DOI: 10.1016/j.reprotox.2015.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 01/10/2023]
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Zamani Z, Zare S, Sadrkhanlou R, Ahmadi A, Movahed E. Chlorpromazine-Induced Hyperprolactinemia on Rat's Uterus. IRANIAN BIOMEDICAL JOURNAL 2015; 19:226-32. [PMID: 26239213 PMCID: PMC4649858 DOI: 10.7508/ibj.2015.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Hyperprolactinemia is a common side effect of antipsychotic drugs that requires further investigation. The current study was designed to evaluate dose-dependent effect of chlorpromazine (CPZ) on hormonal changes and uterine horn histological structure in rats. Moreover, the mammary glands were analyzed to show hyperprolactinemia-induced histological changes. Methods: Albino Wistar rats (n = 32) were divided into four groups. The first group was set as a control. In the three drug-treated groups (eight rats in each group), CPZ was administered by a gavage at doses of 3, 10, and 30 mg/kg/day for 28 days. One day after the last administration of the drug, the animals were sacrificed. Histopathological and histomorphometrical analyses of the uterine horns and mammary glands were carried out to evaluate dose-dependent effect of CPZ on histological structure. Serum levels of prolactin (PRL), estradiol, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were also evaluated. Results: Remarkable (P < 0.05) elevation was observed in CPZ-administrated animals' uterine horn endometrium, myometrium, and perimetrium thicknesses, and the mammary glands were observed with galactorrhea features. The serum level of progesterone and PRL significantly (P < 0.05) increased, while the serum concentration of LH, FSH, and estradiol was notably (P < 0.05) decreased depending on administrated CPZ dose. No histological and biological changes were occurred in the control animals. Conclusion: The present findings suggest that CPZ-induced disturbances not only depend on PRL level and increased PRL level largely depends on administrated doses of the CPZ.
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Affiliation(s)
- Zahra Zamani
- Dept. of Biology, Faculty of Science, Urmia University, Urmia, Iran
| | - Samad Zare
- Dept. of Biology, Faculty of Science, Urmia University, Urmia, Iran
| | - Rajabali Sadrkhanlou
- Laboratory of Embryology, Dept. of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Abbas Ahmadi
- Laboratory of Embryology, Dept. of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Elham Movahed
- Dept. of Biology, Faculty of Science, Urmia University, Urmia, Iran
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Petronijevic N, Sopta J, Doknic M, Radonjic N, Petronijevic M, Pekic S, Maric N, Jasovic-Gasic M, Popovic V. Chronic risperidone exposure does not show any evidence of bone mass deterioration in animal model of schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2013; 46:58-63. [PMID: 23811489 DOI: 10.1016/j.pnpbp.2013.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 05/27/2013] [Accepted: 05/29/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND It has been shown that bone mass is centrally regulated. Thus schizophrenia being a disease of the central nervous system is an interesting model for studying bone. Most second generation antipsychotic drugs including risperidone are used in the treatment of schizophrenia. Weight gain and metabolic disturbances are common side effects. OBJECTIVE The aims of this study were to investigate bone mass, body composition and light microscopic pathology examinations of femur in an animal model of schizophrenia (pharmacologically induced by postnatally administered phencyclidine-PCP) and to further examine the effects of chronic treatment with risperidone on these parameters in rats. METHODS Four groups of male rats were studied:1) control group-NaCl postnatally administered, n=9; 2) PCP group-postnatal PCP administration to rat pups (on day 2,6,9 and 12), n=6; 3) risperidone group-rats treated with risperidone alone for 9weeks from day 35 (NaCl-RSP group, n=7); 4) PCP rats treated with risperidone for 9weeks from day 35 (PCP-RSP group, n=7). Bone mass and body composition were measured in vivo by dual X ray absorptiometry (areal DXA and fat mass). Light microscopic analysis of the femoral metaphysis was performed in all groups after sacrificing the animals. RESULTS Postnatal phencyclidine (PCP) administration to rat pups caused a long lasting reduction of total bone mass versus control animals (aDXA 128±2mg/cm(2) vs 139±5mg/cm(2), p<0.05). Examination of the femoral bone revealed a decrease in the number and thickness of the metaphyseal trabecule and cortical thinning. There was a decrease in total and retroperitoneal fat. Nine weeks of administration of risperidone alone to rats, resulted in significant weight gain and had no effect on bone mass versus control animals (aDXA was 136±7mg/cm(2) vs 139±5mg/cm(2), p>0.05). Furthermore, there were no changes in the light microscopic analysis of femoral metaphysis in comparison with controls. When PCP rats were treated with risperidone, they did not change their body weight nor bone mass versus PCP alone (aDXA 126±2mg/cm(2) vs 128±2mg/cm(2), p>0.05) but intriguingly on examination of the femoral bone an increase in the number and thickness of the metaphyseal trabecule was found (trabecular thickness 0.6±0.1μm vs 0.35±0.1μm, p<0.01). CONCLUSION This study shows that in the PCP rat model of schizophrenia bone mass is reduced. When PCP rats were treated with risperidone bone mass remained unchanged but intriguingly and unexpectedly light microscopic examination of femoral metaphysis showed an increase in thickness of metaphyseal trabeculae. The mechanism of risperidone's action on bone remains to be clarified.
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Affiliation(s)
- Natasa Petronijevic
- Institute of Biochemistry, University of Belgrade, Serbia; School of Medicine, University of Belgrade, Serbia
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Calarge CA, Ivins SD, Motyl KJ, Shibli-Rahhal AA, Bliziotes MM, Schlechte JA. Possible mechanisms for the skeletal effects of antipsychotics in children and adolescents. Ther Adv Psychopharmacol 2013; 3:278-93. [PMID: 24167704 PMCID: PMC3805387 DOI: 10.1177/2045125313487548] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The increasing use of antipsychotics (APs) to treat pediatric psychiatric conditions has led to concerns over the long-term tolerability of these drugs. While the risk of cardiometabolic abnormalities has received most of the attention, preclinical and clinical studies provide preliminary evidence that APs can adversely impact bone metabolism. This would be most concerning in children and adolescents as suboptimal bone accrual during development may lead to increased fracture risk later in life. However, the potential mechanisms of action through which APs may impact bone turnover and, consequently, bone mineral content are not clear. Emerging data suggest that the skeletal effects of APs are complex, with APs directly and indirectly impacting bone cells through modulation of multiple signaling pathways, including those involving dopamine D2, serotonin, adrenergic, and prolactin receptors, as well as by affecting gonadotropins. Determining the action of APs on skeletal development is further complicated by polypharmacy. In children and adolescents, APs are frequently coprescribed with psychostimulants and selective serotonin reuptake inhibitors, which have also been linked to changes in bone metabolism. This review discusses the mechanisms by which APs may influence bone metabolism. Also covered are preclinical and pediatric findings concerning the impact of APs on bone turnover. However, the dearth of clinical information despite the potential public health significance of this issue underscores the need for further studies. The review ends with a call for clinicians to be vigilant about promoting optimal overall health in chronically ill youth with psychopathology, particularly when pharmacotherapy is unavoidable.
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Affiliation(s)
- Chadi A Calarge
- Associate Professor, Departments of Psychiatry and Pediatrics, University of Iowa Carver College of Medicine, Psychiatry Research, 2-209 MEB, 500 Newton Road, Iowa City, IA 52242, USA
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Abstract
Psychotropic drugs are a crucial element of treatment for psychiatric disorders; however there is an established association between many classes of psychotropic medications and fracture risk among older adults, and growing evidence that some classes of medications may also impact bone mineral density (BMD). In this paper we review recent epidemiologic research on the association between psychotropic medications and osteoporosis, and discuss current controversies and unresolved issues surrounding this relationship. Key areas in need of focused inquiry include resolving whether the apparent association between psychotropic medications and BMD is due to confounding by indication, whether this relationship differs for men and women, and whether the implications of these medications for bone health vary over the life course. Clinical research to delineate the risk/benefit ratio of psychotropic medications for older adults, particularly those who are at high risk for fracture, is also needed to facilitate prescribing decisions between patients and physicians.
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Affiliation(s)
- Monique J Brown
- Department of Epidemiology and Community Health, Virginia Commonwealth University School of Medicine, Richmond, 23238, USA
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Mechanistic investigations on the etiology of Risperdal® Consta®-induced bone changes in female Wistar Hannover rats. Toxicology 2012; 299:90-8. [DOI: 10.1016/j.tox.2012.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 05/04/2012] [Accepted: 05/05/2012] [Indexed: 11/21/2022]
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Abstract
PURPOSE OF REVIEW Excessive bone mineral density (BMD) loss has been associated with schizophrenia, but its mechanisms and clinical implications are less clear. The aim of this review was to summarize the risk of osteoporosis and bone fractures in schizophrenia patients. Moreover, we aimed to examine the impact of antipsychotic-induced hyperprolactinemia on bone metabolism. RECENT FINDINGS Fifteen of 16 studies (93.8%) reported lower BMD or higher prevalence of osteoporosis in at least one region, or in at least one subgroup of schizophrenia patients compared with controls, but results were inconsistent across measured areas. Higher fracture risk was associated with schizophrenia in 2/2 studies (independently: n = 1), and 3/4 studies with antipsychotics. Reasons for this difference include insufficient exercise, poor nutrition, smoking, alcohol use, and low vitamin D levels. Altogether, 9/15 (60.0%) studies examining the relationship between antipsychotic-induced hyperprolactinemia and BMD loss found some effects of hyperprolactinemia. However, results were mixed, samples and effects were small, and only two studies were prospective. SUMMARY Schizophrenia is associated with reduced BMD and fracture risk. Prevention, early detection, and intervention are required. The relative contributions of antipsychotic-related hyperprolactinemia and unhealthy lifestyle behaviors remain unclear, needing to be assessed in well designed, prospective studies, including bone turnover markers as intermediary endpoints.
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Affiliation(s)
- Taishiro Kishimoto
- The Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, New York, USA
- Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Marc De Hert
- University Psychiatric Center, Catholic University Leuven, Kortenberg, Belgium
| | - Harold E. Carlson
- Endocrinology Division, Stony Brook University School of Medicine, Stony Brook, New York, USA
| | - Peter Manu
- The Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, New York, USA
- Hofstra North Shore LIJ School of Medicine, Hempstead, New York, USA
- Albert Einstein College of Medicine, Bronx, New York, USA
- Transilvania University, Brasov, Romania
| | - Christoph U. Correll
- The Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, New York, USA
- Hofstra North Shore LIJ School of Medicine, Hempstead, New York, USA
- Albert Einstein College of Medicine, Bronx, New York, USA
- The Feinstein Institute for Medical Research, Manhasset, New York, USA
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Bishop JR, Rubin LH, Reilly JL, Pavuluri MN, Sweeney JA. Risperidone-associated prolactin elevation and markers of bone turnover during acute treatment. Ther Adv Psychopharmacol 2012; 2:95-102. [PMID: 23983962 PMCID: PMC3736917 DOI: 10.1177/2045125312442080] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Prolactin elevation has been proposed as a risk factor for low bone density and potentially osteoporosis in patients on long-term treatment with prolactin-elevating antipsychotics. Our objective was to study the acute effects of prolactin elevation on serum markers of bone formation and resorption in patients treated with risperidone. METHODS Thirty participants meeting Diagnostic and Statistical Manual of Mental Disorders fourth edition criteria for schizophrenia, major depressive disorder with psychotic features, or bipolar disorder with psychosis were enrolled. At baseline, subjects were antipsychotic free. Subjects were evaluated before and after 4 weeks of risperidone treatment. Assessments included symptom ratings along with testosterone, estradiol, prolactin, osteocalcin (marker of bone formation), and n-telopeptide crosslinks (NTx marker of bone resorption). Primary analysis examined the impact of risperidone treatment on change in the bone markers and hormone levels from pre to post treatment. RESULTS Prolactin levels significantly increased from 12.1 ± 1.9 ng/ml to 65.7 ± 12.2 ng/ml after treatment (p < 0.001). NTx markers of bone resorption significantly decreased from 18.31 ± 1.49 nM bone collagen equivalent (BCE) before treatment to 15.50 ± 1.22 nM BCE after treatment in the study sample as a whole (p < 0.05). A trend was observed indicating that NTx may increase in individuals who have the greatest increases in prolactin after treatment r = 0.33, p = 0.07). CONCLUSIONS These findings suggest that prolactin elevation is associated with changes in bone physiology very early in the course of treatment with risperidone. Bone resorption decreased in many subjects but higher levels of bone resorption occurred in patients with the greatest increases in prolactin. This may have important implications for prolactin monitoring or the periodic assessment of osteoporosis-related outcomes in patients requiring extended treatment.
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Affiliation(s)
- Jeffrey R Bishop
- University of Illinois at Chicago College of Pharmacy, 833 S. Wood St Rm 164 (M/C 886), Chicago, IL 60612, USA
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Crews MPK, Howes OD. Is antipsychotic treatment linked to low bone mineral density and osteoporosis? A review of the evidence and the clinical implications. Hum Psychopharmacol 2012; 27:15-23. [PMID: 22228316 PMCID: PMC3731625 DOI: 10.1002/hup.1265] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 11/19/2011] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Osteoporosis is increasingly common worldwide and there is a growing concern that the long-term use of antipsychotic medications increases the risk of this disorder. In this review, we consider whether antipsychotics may contribute to the development of osteoporosis through reductions in bone mineral density, discuss the possible mechanisms involved and consider the clinical implications of such a relationship. METHODS We searched the literature for studies in this area published between 1966 and 2010 using the Medline and PubMed databases, supplemented by hand searches of retrieved reports. RESULTS The available data indicate that statistically significant reductions in bone mineral density are frequently seen in patients prescribed with antipsychotic medications and suggest that there is a higher incidence of clinically significant reductions compared with the normal population. CONCLUSIONS Clinicians should be aware for the potential negative effects of antipsychotic medications on bone mineral density, particularly in patients with additional risk factors for osteoporosis. Recommendations regarding routine monitoring of bone mineral density for patients prescribed antipsychotic medications cannot be made on the basis of existing evidence, and more research is required.
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Affiliation(s)
- Matthieu P K Crews
- South London and Maudsley NHS Foundation Trust, The Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK.
| | - Oliver D Howes
- King’s College London- Institute of Psychiatry, King’s Health Partners, De Crespigny Park, Camberwell, London, SE5 8AF, UK
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